“Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysis
Background Post-transplantation diabetes mellitus and carbohydrate intolerance (PTDM/iCHO) are complications following solid organ transplantation, which significantly increases the risk of graft loss and mortality. However, data concerning long-term outcomes in paediatric kidney transplant recipien...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2024-12-01
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| Series: | BMJ Paediatrics Open |
| Online Access: | https://bmjpaedsopen.bmj.com/content/8/1/e002710.full |
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| author | Lina Maria Serna-Higuita Maria Alejandra Calvo-Herrera Angelica Maria Serna-Campuzano María Carolina Isaza-Lopez Esteban Villegas-Arbeláez Luisa Fernanda Rojas-Rosas Carolina Lucia Ochoa-García |
| author_facet | Lina Maria Serna-Higuita Maria Alejandra Calvo-Herrera Angelica Maria Serna-Campuzano María Carolina Isaza-Lopez Esteban Villegas-Arbeláez Luisa Fernanda Rojas-Rosas Carolina Lucia Ochoa-García |
| author_sort | Lina Maria Serna-Higuita |
| collection | DOAJ |
| description | Background Post-transplantation diabetes mellitus and carbohydrate intolerance (PTDM/iCHO) are complications following solid organ transplantation, which significantly increases the risk of graft loss and mortality. However, data concerning long-term outcomes in paediatric kidney transplant recipients with PTDM/iCHO are scarce. This study aimed to evaluate the risk of graft loss in paediatric kidney transplant recipients with PTDM or iCHO compared with non-PTDM/iCHO.Methods The study cohort included patients aged <18 who underwent a kidney transplant in a transplant centre from 2005 to 2022. The primary outcome was graft survival loss; secondary outcomes were acute rejection, renal function and mortality. Cumulative incidence of graft loss and acute rejection was estimated, considering death a competing risk. Fine and Gray’s proportional subdistribution hazard model was used to analyse the effect of PTDM/iCHO status on the event.Results Seventy-six paediatric kidney transplant recipients were included. The incidence of PTDM and iCHO was 6.6% and 9.2%, respectively. Patients with PTDM/iCHO had a significantly higher cumulative graft loss incidence than those without (34.4% vs 13.9% at 36 months, p<0.008). Multivariable analysis revealed a threefold increased risk of graft loss in patients with PTDM/iCHO (HRadjusted 3.33, 95% CI 1.19 to 9.30, p=0.022). PTDM/iCHO was associated with a higher incidence of acute rejection (33.3% vs 14.5% at 1 year, p=0.025). Patients with PTDM/iCHO also exhibited significantly worse eGFR at all time points compared with patients without PTDM/iCHO (p=0.036)Conclusion Patients with PTDM and iCHO had a higher risk of graft loss and lower renal function in paediatric kidney transplant recipients. This justifies close monitoring of metabolic complications in these patients. |
| format | Article |
| id | doaj-art-c744a9f74ca24812b4ee044f98769c7e |
| institution | OA Journals |
| issn | 2399-9772 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Paediatrics Open |
| spelling | doaj-art-c744a9f74ca24812b4ee044f98769c7e2025-08-20T01:57:35ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722024-12-018110.1136/bmjpo-2024-002710“Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysisLina Maria Serna-Higuita0Maria Alejandra Calvo-Herrera1Angelica Maria Serna-Campuzano2María Carolina Isaza-Lopez3Esteban Villegas-Arbeláez4Luisa Fernanda Rojas-Rosas5Carolina Lucia Ochoa-García62 Department of Clinical Epidemiology and Applied Biostatistics, Eberhard Karls University, Tübingen, GermanyPediatric Department, University of Antioquia, Medellin, ColombiaDepartment of Nephrology, Hospital Pablo Tobón Uribe, Medellin, ColombiaUniversidad Pontificia Bolivariana, Medellin, Antioquia, ColombiaUniversidad CES Clinica CES, Medellin, Antioquia, ColombiaHospital Universitario General de Medellin, Medellin, ColombiaPediatric Department, University of Antioquia, Medellin, ColombiaBackground Post-transplantation diabetes mellitus and carbohydrate intolerance (PTDM/iCHO) are complications following solid organ transplantation, which significantly increases the risk of graft loss and mortality. However, data concerning long-term outcomes in paediatric kidney transplant recipients with PTDM/iCHO are scarce. This study aimed to evaluate the risk of graft loss in paediatric kidney transplant recipients with PTDM or iCHO compared with non-PTDM/iCHO.Methods The study cohort included patients aged <18 who underwent a kidney transplant in a transplant centre from 2005 to 2022. The primary outcome was graft survival loss; secondary outcomes were acute rejection, renal function and mortality. Cumulative incidence of graft loss and acute rejection was estimated, considering death a competing risk. Fine and Gray’s proportional subdistribution hazard model was used to analyse the effect of PTDM/iCHO status on the event.Results Seventy-six paediatric kidney transplant recipients were included. The incidence of PTDM and iCHO was 6.6% and 9.2%, respectively. Patients with PTDM/iCHO had a significantly higher cumulative graft loss incidence than those without (34.4% vs 13.9% at 36 months, p<0.008). Multivariable analysis revealed a threefold increased risk of graft loss in patients with PTDM/iCHO (HRadjusted 3.33, 95% CI 1.19 to 9.30, p=0.022). PTDM/iCHO was associated with a higher incidence of acute rejection (33.3% vs 14.5% at 1 year, p=0.025). Patients with PTDM/iCHO also exhibited significantly worse eGFR at all time points compared with patients without PTDM/iCHO (p=0.036)Conclusion Patients with PTDM and iCHO had a higher risk of graft loss and lower renal function in paediatric kidney transplant recipients. This justifies close monitoring of metabolic complications in these patients.https://bmjpaedsopen.bmj.com/content/8/1/e002710.full |
| spellingShingle | Lina Maria Serna-Higuita Maria Alejandra Calvo-Herrera Angelica Maria Serna-Campuzano María Carolina Isaza-Lopez Esteban Villegas-Arbeláez Luisa Fernanda Rojas-Rosas Carolina Lucia Ochoa-García “Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysis BMJ Paediatrics Open |
| title | “Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysis |
| title_full | “Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysis |
| title_fullStr | “Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysis |
| title_full_unstemmed | “Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysis |
| title_short | “Effect of post-kidney transplant diabetes mellitus on long-term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022.” Survival analysis |
| title_sort | effect of post kidney transplant diabetes mellitus on long term outcomes in a cohort of pediatric kidney transplant recipients from 2005 to 2022 survival analysis |
| url | https://bmjpaedsopen.bmj.com/content/8/1/e002710.full |
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